Don’t opt-out patients by default, GPs advised

GP practices concerned about the confidentiality of patient records under the NHS Care Records Service have been advised not to opt-out all their patients by default.

EHI Primary Care has learnt that some GPs are considering adding the code 93c3(refused consent for upload to national electronic shared record) to all patients in order to prevent patients’ details being uploaded to the spine without their consent.

Concern among GPs about the consent model for the NCRS has grown since the Department of Health (DH) refused to accept opt-outs from patients who had submitted a coupon from the Guardian newspaper http://www.ehiprimarycare.com/news/item.cfm?ID=2316

However both the British Medical Association’s General Practitioner Committee and the Medical Protection Society (MPS) have advised GPs not to do so.

Dr Richard Vautrey, a GP in Leeds and GP negotiator, told EHI Primary Care: “I think it is too early to do that just yet. We fully support patients who do want to opt out but it’s a bit premature to do so before the information campaign has started and patients are fully informed about their decision to opt out.”

Dr Vautrey said the BMA had raised its concerns with the DH over its rejection of patients’ requests to opt-out but had not reached a satisfactory conclusion with the DH. “It’s an area that we all want to resolve. We believe that in acting it the way that they have done they will only undermine patients’ confidence in the system and make them suspicious of ulterior motives.”

An MPS spokesperson said a blanket opt-out on behalf of all patients was not the most appropriate way forward. She added: “The key point is that the opt-out should be a patient’s decision and if practices did decide to do this they would need to inform all the patients first and make sure they had chance to make a fully informed decision to opt-in.”

The MPS said its members had already been contacting the society in relation to patients’ rights under the electronic database.

Dr Nick Clements, MPS senior medico-legal adviser, added: “Where a patient contacts their practice to ask for a record to be made of their objection to their details being uploaded to the national record, the practice should acknowledge their request, and arrange for the objection to be noted in the patient’s record, both written and electronic.

“As the process for objecting is still not finalised, it would be good practice to inform the patient of this and to suggest that they also register their objection with the PCT and with the Department of Health. As the position evolves over time, patients’ rights should become clearer, and having their record appropriately "tagged" with their objection will enable those rights to be properly respected in due course. The practice does not have an obligation to take further steps at present, particularly as the process in question is still not finalised.”